Children's Health: Ritalin vs. Omega 3 Fatty Acids

Children's Health: Ritalin vs. Omega 3 Fatty AcidsChildren's Health: Ritalin vs. Omega 3 Fatty Acids

ADHD is medical term that describes children who are chronically inattentive, impulsive, and hyperactive. They often have problems both at home and school. As they grow up they are more likely to drop out of high school and experience patterns of antisocial behavior.

The most commonly prescribed medical drug for ADHD is Ritalin. But, most recently, the manufacturers of Ritalin, and other interested parties, have come under attack for alleged over promotion of the drug.

In May 2000, a Dallas law firm filed a lawsuit against the Swiss drug company Novartis AG which manufacturers Ritalin.1 The suit seeks class-action status on behalf of people who bought Ritalin for their children. Also named in the suit were the American Psychiatric Association and the advocacy group Children and Adults with Attention-Deficit Hyperactivity Disorder, in Landover, Maryland; both were alleged to have generated concern about the condition while promoting Ritalin and receiving funding from Novartis. Although Novartis has called the lawsuit "without merit" and vowed to "vigorously" defend itself, it is predicted that numerous other suits will soon be filed.

Ritalin (methylphenidate), Dexedrine and Adderall are stimulants. "None of these drugs will cure ADHD," notes Andrew Adesman, M.D.2 "But when they're effective, they can improve attention, reduce restlessness, and foster better relations with peers, parents, and teachers. Each of the three stimulant medications has roughly a 75 percent response rate." But when all are used, until one is found to be effective, the response rate is said to be 90 percent.

One-a-Day Ritalin on the Way
Because children often require multiple doses of the drugs and it is difficult to insure compliance, the drug firm Noven Pharmaceuticals, Inc., of Miami, Florida, is now researching a kids one-a-day Ritalin, as well as a Ritalin patch.3 Meanwhile Celgene Corp. is working with Novartis to market a highly purified form of Ritalin that is said to be an IQ booster as well.

This is dangerous. This is very dangerous.

Ritalin Dangers
According to an October 20, 1995
Drug Enforcement Administration bulletin:

  • Methylphenidate (MPH), most commonly known as Ritalin, ranks in the top 10 most frequently reported controlled pharmaceuticals stolen from licensed handlers.
  • Abuse of MPH can lead to marked tolerance and severe psychological dependence.
  • Organized drug trafficking groups in a number of states have utilized various schemes to obtain MPH for resale on the illicit market.
  • MPH is abused by diverse segments of the population, from health care professionals and children to street addicts.
  • A significant number of children and adolescents are diverting or abusing MPH medication intended for the treatment of ADHD.
  • In 1994, a national high school survey (Monitoring the Future) indicated that more seniors in the U.S. abuse Ritalin than are prescribed Ritalin legitimately.
  • Students are giving and selling their medication to classmates who are crushing and snorting the powder like cocaine. In March of 1995, two deaths in Mississippi and Virginia were associated with this activity.
  • DAWN statistics on estimated emergency room mentions indicate that there were 271 mentions in 1990, 657 mentions in 1991, 1,044 mentions in 1992 and 725 in 1993 (of which 28 percent to 40 percent were associated with abuse for dependence for psychological effects). The number of mentions for MPH was significantly greater than mentions for Schedule II stimulants (six mentions in 1992 and one mention in 1993 for Schedule III stimulants).
  • The U.S. manufactures and consumes five times more MPH than the rest of the world combined.
  • MPH aggregate production quota has increased almost 6-fold since 1990.
  • Ritalin may be cancer-causing.


The Texas lawsuit and others that will follow, we believe, will make this clear.

Is your child on Ritalin? Do school officials want you to put your child on Ritalin because of his or her poor behavior, lack of concentration, or learning skills?

We believe that while Ritalin and related amphetamine drugs are sometimes effective, they should never be a first choice for children diagnosed with ADHD. In fact, there are other pathways for overcoming ADHD without reliance on drugs (that often must be taken even into adulthood).

You'll want to know about the growing medical evidence that omega-3 fatty acids may also help without the dangerous complications of Ritalin.

?Omega-3 Fatty Acids and Children's's Behavior:
Promising Evidence for a Nutritional Cure
"ADHD children also tend to have more allergies, eczema, asthma, headaches, stomachaches, ear infections and dry skin than non-ADHD youngsters," note authors and researchers Donald Rudin, M.D. and Clara Felix.4 (Rudin received his medical degree from Harvard Medical School and from 1957 to 1980 served as the director of the Department of Molecular Biology at the Eastern Pennsylvania Psychiatric Institute, Philadelphia. Felix received her B.S. in nutrition from the University of California, Berkeley. Together, they authored Omega-3 Oils: A Practical Guide.) Both Rudin and Felix claim that these problems, including ADHD, are part of a modernization-disease syndrome, which arises from malnutrition centered on an omega-3 fatty acid deficiency.

Their contention is supported by growing evidence. The connection between omega-3 fatty acid deficiency and ADHD has been confirmed by studies in which youngsters with ADHD, when compared with non-ADHD children, had much lower blood levels of docosahexaenoic Acid (DHA), an omega-3 fatty acid necessary for normal function of the eyes and the cerebral cortex (the brain region that handles higher functions such as reasoning and memory).

How Omega-3 Fatty Acids Help ADHD Children
All cells throughout the human body are enveloped by membranes composed chiefly of essential fatty acids in the form of phospholipids, notes Michael Murray, N.D. Phospholipids play a major role in determining the integrity and fluidity of cell membranes. What determines the type of phospholipid in the cell membrane is the type of fat consumed. Unfortunately, our children's diets which may be ladened with saturated and polyunsaturated fats from beef, dairy, and corn oil interfere with the optimal balance of phospholipids in cell membranes.

A phospholipid composed of a saturated fat or trans-fatty acid differs considerably in structure from a phospholipid composed of an essential fatty acid. In addition, there are differences between the structure of an omega-3 oil composed membrane and an omega-6 composed membrane, says Dr. Murray. Up to 80 percent of the fatty acids in the cerebral cortex of the brain should be composed of omega-3 fatty acids. (Food sources particularly rich in omega-3 fatty acids include cold water fish and flaxseed oil.)

It is thought the cell is programmed to selectively incorporate the different fatty acids it needs to maintain optimal function. In actuality, what becomes incorporated into the cell membranes is determined primarily by diet. A diet composed of largely saturated fat, animal fatty acids, cholesterol, and trans-fatty acids, such as the American diet, is going to lead to membranes which are much less fluid in nature compared to the membranes of an individual consuming optimal levels of both essential fatty acids.

"A relative deficiency of essential fatty acids in cellular membranes makes it virtually impossible for the cell membrane to perform its vital functions," says Dr. Murray. "The basic function of the cell membrane is to serve as a selective barrier that regulates the passage of certain materials in and out of the cell. When there is a disturbance of structure or function of the cell membrane, there is a tremendous disruption of homeostasis. This term, homeostasis, refers to the maintenance of static conditions in the internal environment of the cell and, on a larger scale, the human body as a whole. In other words, with a disturbance in cellular membrane structure or function, there is disruption of virtually all cellular processes." "Because the brain is the richest source of phospholipids in the human body and accurate nerve cell function is critically dependent on proper membrane fluidity, it only makes sense that alterations in membrane fluidity could dramatically impact behavior, mood, and mental function," adds Dr. Murray. In addition, studies have shown the biophysical properties, including fluidity of synaptic membranes directly influences neurotransmitter synthesis, signal transduction, uptake of serotonin and other neurotransmitters, and neurotransmitter binding. All of these factors have been implicated in depression and other psychological disturbances in children.

Scientific Evidence
Two types of fatty acids are considered essential. Omega-3 and omega-6 fatty acids cannot be synthesized in the body, and must be obtained from the diet. The omega-6 fatty acids are distributed evenly in most tissues and easily obtained through food sources commonly found in the American diet, but omega-3 fatty acids are concentrated in a few tissues including the brain.5, 6 Because of their relative scarceness in the American diet, many children, perhaps a majority of children today are deficient in omega-3 fatty acids. Learning specialists now believe omega-3 fatty acid deficiency leads to unique symptoms during childhood, including behavioral problems.7, 8

The evidence is certainly suggestive:
  • In 1981, researchers first hypothesized that children with ADHD may have reduced nutritional status of essential fatty acids because they showed greater thirst (a symptom of essential fatty acid deficiency) compared to children without ADHD.9

  • These results were further confirmed in 1983. When essential fatty acids were examined in 23 maladjusted children and 20 normal children, essential fatty acids blood levels in poorly behaved children were significantly lower.10

  • In 1987, researchers further documented that 48 children with ADHD reported significantly greater thirst, more frequent urination, and more health and learning problems than children without ADHD.11 Significantly lower levels of two omega-6 fatty acids and one omega-3 fatty acid (DHA) were found in the subjects with ADHD symptoms.

  • In a 1995 study comparing plasma essential fatty acid levels in 53 boys with ADHD to a control group of 43 boys without ADHD, researchers found significantly lower levels of omega-3 fatty acids.12

  • In the April-May 1996 issue of Physiology & Behavior 1996, Laura J. Stevens, of the Department of Foods and Nutrition, Purdue University, and co-investigators published an extremely important paper.13 The researchers found that boys with lower levels of omega-3 fatty acids in their blood showed more problems with behavior, learning, and health than those with higher levels of total omega-3 fatty acids.

  • Also, in 1996, researchers from the Department of Psychiatry, Technical University, Faculty of Medicine, Trabzon, Turkey, reported that levels of free fatty acids as well as zinc were several-fold lower in ADHD children compared to non-ADHD children.14

  • Most recently, researchers performed a study to test the effect of omega-3 fatty acids on intelligence scores among 56 18-month-old children.15 The children were divided into three groups, one that received DHA, one that received DHA and alpha-linolenic acid (the master omega-3 fatty acid found in flaxseed), and one that received a formula that did not contain either. All children were enrolled in the study within five days of birth and received one of the three formulas for 17 weeks. The children's overall intelligence and motor skills were tested using the latest Bayley Scales of Infant Development (BSID), the standard for gauging the development of small children. No differences were seen in the Psychomotor Development Index. On the Mental Development Index, which measures memory, ability to solve simple problems and language capabilities, the children in the control group received an average score of 98, slightly below the national average of 100. The DHA group received an average score of 102.4 and the DHA and alpha-linolenic acid group received an average score of 105.1. The children will be tested again in four years to see if the gains continue into early childhood.

    Children

    The Doctors Prescription
    This is crucial information, especially for parents of children who are diagnosed with ADHD and who are presently being prescribed Ritalin. "We shouldn't be prescribing medicine simply because that's the easiest way to go," notes Dr. Mark Stein, who runs a University of Chicago clinic for children and adults with the disorder.

    While all children with ADHD are not deficient in omega-3 fatty acids, we believe that this may be important for at least a subset of ADHD children.

    In fact, studies show that children whose treatment program includes only medication, educational and psychological therapy continue to be at high risk for vandalism, petty crime, frequency of alcoholic intoxication, and possession of marijuana. Dietary improvements may be the key to fostering long-term health and acceptable behavior.

    Parents of ADHD children and ADHD adults who wish to utilize omega-3 fatty acids as a method of modifying their behavior should use both flax and seafood sources of omega-3 fatty acids. Flax provides alpha-linolenic acid, the master omega-3 fatty acid from which other omega-3 fatty acids are synthesized. Seafood provides DHA directly which appears to be a vital omega-3 fatty acid for modifying behavior of ADHD children and adults. The rate of conversion of ALA to DHA is quite low. However, alpha-linolenic acid may be important to behavioral improvements as well. Therefore, a combination of flax and seafood is best. Thus, flax, which can be inconspicuously incorporated into children's meals, holds many benefits.

    Flax oil can be used in salad dressings and in smoothies as well as many other tasty dishes. Although many people believe that flax oil is too fragile to be used as a cooking oil, this may not be true, reports Felix.

    "The recorded use of flaxseed oil as a cooking oil goes as far back as nine thousand years in area of the Near East," she says.16 "Soldiers of the Roman Empire marched with rations of bread baked with flaxseed. China, the third largest flax grower in the world, has used flaxseed as a food oil for at least five thousand years. Germany uses 66,000 tons of flaxseed a year in baked breads and buns.

    Recent studies show little or no loss of alpha-linolenic acid when milled flaxseed is baked as an ingredient in muffins or breads. Cooking also doesn't cause alpha-linolenic acid or other fatty acids to oxidize (break down). Baking and cooking seldom expose fats and oils to temperature above the boiling point (212°F or 100°C)."

    Made to OrderHow to Find the Best Lignan Flax Oil
    We recommend the equivalent of one to two tablespoons of a quality flax oil product. Be sure the company that produces your flax is M.A.D. about fresh lignan flax oil. Here's what to look for when it comes to being M.A.D. about fresh flax:

  • Made to Order. Be sure your flax oil is made to order. Most nutritional oil companies rely on third-party distributors to stock, inventory and ultimately deliver their products to market, sometimes months after manufacturing. For this reason, most flaxseed oil today is dated for freshness for up to one year. This is too long for a perishable electron-rich live food, like flaxseed oil. What's more, these products are typically shipped by ground transportation resulting in prolonged delivery and conditions such as high heat that may degrade the oil. Worse yet, some companies have resorted to refining and or filtering their oil in order to artificially extend shelf life. Be sure your flax oil is made to order, and that the oil is pressed the day it is ordered.

  • Air Delivered. Once fresh pressed, be sure your flax oil is rushed by air delivery manufacturer-direct to your favorite natural health center or health professional, arriving within days of being made.

  • Dated for Freshness. Be sure your flax oil comes coded with both a Fresh Pressed date and a Freshest Before date stamp spanning a period of only four months for maximum potency and freshness. Prolonged distributor delivery and warehoused product makes it necessary for other brands to date stamp their oil for six to twelve months. Good for them, not so good for you.

    This service is called Fresh ExPress and it guarantees you the absolute freshest flax oil anywhere. You will find this type of extremely high-quality lignan flax oil in the refrigerator sections of natural health centers nationwide.

    References:
    1. Long, M. & Barrett, P. "Lawsuit is filed against Novartis on Ritalin sales." The Wall Street Journal Europe, May 15, 2000: 4.
    2. Adesman, A. "Does my child need Ritalin?" Newsweek, April 24, 2000: 81.
    3. footnote* Parker-Pope, T. "Drug firms research kids one-a-day Ritalin?" The Wall Street Journal Europe, May 15, 2000: 31.
    4. Rudin, D. & Felix, C. Omega-3 Oils: A Practical Guide. Garden City Park, NY: Avery Publishing, 1996.
    5. footnote* Neuringer, M. & Conner, W.E. "N-3 fatty acids in the brain and retina: evidence for their essentiality." Nutrition Reviews, 1985; 44: 285-294.
    6. Tinoco, J. "Dietary requirement and function of alpha-linolenic acid in animals." Prog. Lipid. Res, 1982; 21: 1-45.
    7. Enslen, M., et al. "Effect of low intake of n-3 fatty acids during the development of brain phospholipid fatty acid composition and exploratory behavior in rats." Lipids, 1991; 26: 203-208.
    8. Reisbick, S., et al. "Home cage behavior or rhesus monkeys with long-term deficiency of omega-3 fatty acids." Physiol. Behav., 1994; 55: 231-239.
    9. Colquhoun, I. & Bunday, S. "A lack of essential fatty acids as a possible cause of hyperactivity in children." Med. Hypotheses, 1981; 7: 673-679.
    10. Mitchell E.A., et al. "Essential fatty acids and maladjusted behaviour in children." Prostaglandins Leukot Med, 1983; 12(3):281-7.
    11. Mitchell.,. E., et al. "Clinical characteristics and serum essential fatty acid levels in hyperactive children." Clin. Pediatr., 1987; 26: 406-411.
    12. Stevens, L., et al. "Essential fatty acid metabolism in boys with attention-deficit hyperactivity disorder." American Journal of Clinical Nutrition, 1995; 62: 000-000.
    13. Stevens, L., et al. "Omega-3 fatty acids in boys with behavior, learning, and health problems." Physiology & Behavior, April/May 1996.
    14. Bekaröglu, M., et al. "Relationships between serum free fatty acids and zinc, and attention deficit hyperactivity disorder: a research note." J Child Psychol Psychiatry, 1996;37(2):225-227.
    15. Developmenttal Medicine & Child Neurology, 2000; 42:174-181.
    16. Felix, C. All About Omega-3 Oils. Garden City Park, NY: Avery Publishing, 1998.

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